PMID- 27472728
OWN - NLM
STAT- MEDLINE
DCOM- 20170214
LR  - 20210109
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Print)
IS  - 0025-7974 (Linking)
VI  - 95
IP  - 30
DP  - 2016 Jul
TI  - Catheter ablation versus medical rate control for persistent atrial fibrillation 
      in patients with heart failure: A PRISMA-compliant systematic review and 
      meta-analysis of randomized controlled trials.
PG  - e4377
LID - 10.1097/MD.0000000000004377 [doi]
LID - e4377
AB  - BACKGROUND: The effectiveness of restoring the sinus rhythm by catheter ablation 
      relative to that of medical rate control for persistent atrial fibrillation (AF) 
      patients with heart failure (HF) remains to be defined. METHODS: We 
      systematically searched Embase, Pubmed, the Cochrane Library, and 
      ClinicalTrials.gov for articles that compared the outcomes of interest between 
      catheter ablation and medical rate control therapy in persistent AF patients with 
      HF and left ventricular systolic dysfunction (LVSD). The primary endpoint was the 
      change in the left ventricular ejection fraction (LVEF) following catheter 
      ablation or medical rate control therapy relative to baseline. Other endpoints 
      included changes in cardiac function and exercise capacity, including the New 
      York Heart Association (NYHA) class, the brain natriuretic peptide (BNP) level, 
      the peak oxygen consumption (peak VO2), the 6-minute walk test (6MWT) results, 
      and quality of life (QOL). RESULTS: Three randomized controlled trials (RCTs) 
      with 143 patients were included. At the overall term follow-up, catheter ablation 
      significantly improved the LVEF (mean difference [MD]: 6.22%; 95% confidence 
      interval [CI]: 0.7-11.74, P = 0.03) and peak VO2 (MD: 2.81 mL/kg/min; 95% CI: 
      0.78-4.85, P = 0.007) and reduced the NYHA class (MD: 0.9; 95% CI: 0.59-1.21, 
      P < 0.001) and the Minnesota Living with Heart Failure Questionnaires (MLHFQ) 
      scores (MD: -11.05; 95% CI: -19.45 - -2.66, P = 0.01) compared with the medical 
      rate control for persistent AF patients with HF. Alterations in parameters, such 
      as the BNP level, 6MWT, and Short Form-36 (SF-36) questionnaire scores also 
      revealed trends that favored catheter ablation therapy, although these 
      differences were not significant. CONCLUSION: Catheter ablation resulted in 
      improved LVEF, cardiac function, exercise capacity, and QOL for persistent AF 
      patients with HF compared with the medical rate control strategy.
FAU - Zhu, Min
AU  - Zhu M
AD  - Department of Cardiology, First Affiliated Hospital of Zhejiang Chinese Medical 
      University Department of Pharmacy, Second Affiliated Hospital, Zhejiang 
      University School of Medicine, Hangzhou, Zhejiang, China.
FAU - Zhou, Xinbin
AU  - Zhou X
FAU - Cai, Hongwen
AU  - Cai H
FAU - Wang, Zhijun
AU  - Wang Z
FAU - Xu, Huimin
AU  - Xu H
FAU - Chen, Shenjie
AU  - Chen S
FAU - Chen, Jie
AU  - Chen J
FAU - Xu, Xiaoming
AU  - Xu X
FAU - Xu, Haibin
AU  - Xu H
FAU - Mao, Wei
AU  - Mao W
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PT  - Systematic Review
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (Anti-Arrhythmia Agents)
SB  - IM
MH  - Anti-Arrhythmia Agents/*therapeutic use
MH  - Atrial Fibrillation/*therapy
MH  - *Catheter Ablation
MH  - Heart Failure/*therapy
MH  - Humans
MH  - Patient Safety
MH  - Randomized Controlled Trials as Topic
MH  - Treatment Outcome
PMC - PMC5265865
COIS- The authors have no conflicts of interest to disclose.
EDAT- 2016/07/30 06:00
MHDA- 2017/02/15 06:00
PMCR- 2016/07/29
CRDT- 2016/07/30 06:00
PHST- 2016/07/30 06:00 [entrez]
PHST- 2016/07/30 06:00 [pubmed]
PHST- 2017/02/15 06:00 [medline]
PHST- 2016/07/29 00:00 [pmc-release]
AID - 00005792-201607260-00064 [pii]
AID - 10.1097/MD.0000000000004377 [doi]
PST - ppublish
SO  - Medicine (Baltimore). 2016 Jul;95(30):e4377. doi: 10.1097/MD.0000000000004377.